Evidence map›Paper›PMID 40501196›Full record

ArticleBritish journal of health psychology2025

Assessing moral injury in health care workers living in secular societies: Introducing the Health care-Moral Injury Scale (HMIS).

Kathryn Fradley, Fuschia Sirois, Richard Bentall, Jaydip Ray, Rhian Bishop, Jonathan Wadsley, Sarah Danson

Abstract read
In one paragraph

Article in British journal of health psychology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kathryn FradleySchool of Nursing and Public Health, Manchester Metropolitan University, Manchester, UK.ORCID 0000-0002-2443-7368
Fuschia SiroisDepartment of Psychology, Durham University, Durham, UK.ORCID 0000-0002-0927-277X
Richard BentallDepartment of Psychology, University of Sheffield, Sheffield, UK.
Jaydip RayDepartment of Neuroscience, University of Sheffield, Sheffield, UK.
Rhian BishopSheffield Teaching Hospital NHS Trust, Sheffield, UK.
Jonathan WadsleySheffield Teaching Hospital NHS Trust, Sheffield, UK.
Sarah DansonSheffield Teaching Hospital NHS Trust, Sheffield, UK.

Funding

Sheffield Hospitals Charity
6 · The paper itself

Abstract

purposeThe adverse impact of moral injury on health care workers is well documented, for example during the COVID-19 pandemic. However, currently available measures are unsuitable for assessing moral injury in health care workers living in secular societies such as the United Kingdom. The current study introduces and validates the Health care-Moral Injury Scale (HMIS).

methodThe 10-item HMIS was designed during the COVID-19 pandemic to assess moral injury in health care workers. Between September and October 2020, 858 health care workers completed the scale and other measures. A factor structure was identified by exploratory and confirmatory factor analysis and correlations were used to test the convergent (burnout, hope, mistrust) and divergent (loneliness) validity of the HMIS. Regression analyses tested the criterion-related validity of the HMIS against measures of depression, anxiety and PTSD. RESULTS AND

conclusionsThe HMIS was found to be a unidimensional scale comprised of three conceptual components. There was evidence of good convergent validity, with a medium-sized correlation between the total moral injury score and burnout. However, correlations were weaker for loss of hope and loss of trust. Moral injury was not significantly associated with loneliness when controlling for mental health difficulties, indicating good divergent validity. Moral injury scores predicted worse severity of depression, anxiety and PTSD, supporting criterion-related validity. Findings suggest that the HMIS is a valid scale that can be used by researchers to assess moral injury specifically in a health care context.

Indexed as

Burnout, ProfessionalCOVID-19Health PersonnelMoralsAdultFemaleHumansLonelinessMaleMiddle AgedPsychometricsReproducibility of ResultsStress Disorders, Post-TraumaticSurveys and QuestionnairesTrustUnited Kingdomhealth care workersmental healthmoral injurypsychometrics

Identifiers

PMID40501196
PMCPMC12159715

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.